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'Cyberchondria' gives doctors a pain

Physicians frustrated by patients who increasingly use the Internet to self-diagnose — and sometimes 'find' a serious illness that isn't there

By Kristen Kridel, Special to the Tribune

1:14 PM EDT, October 26, 2011

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As a family practitioner in Naperville, Dr. Sheron Brown is used to referring her patients to specialists. She's less accustomed to patients informing her that they need a referral.

But such was the case with a woman who called Brown to say she had been online and determined she had appendicitis. Knowing the woman wouldn't be talking calmly if she were truly in the throes of the condition, Brown set up an appointment for the next day. It turns out the woman had a groin injury.

Internet-fueled self-misdiagnoses can be dangerous, Brown said. "Not everything on the Internet is right," she said. "Second of all, if you don't have training, you don't really know how to interpret it."

From strep throat to HIV, any disease or illness is up for grabs when it comes to self-diagnosing via the Internet. The overload of health information — and misinformation — available with a few clicks can be enough to worry and confuse those with even the most basic symptoms.

Doctors and other observers say that when people develop a symptom — a rash, say, or a cough — it's increasingly common for them to head to the Internet to try to figure out what's wrong, sometimes before seeking attention from a professional.

For those who take that further — using information they glean online to convince themselves they are seriously ill — a new term has sprung up: "cyberchondria."

"There's not a shift that goes by when I don't see a patient who said, 'I looked this up, and I'm worried about this,'" said Dr. Rahul Khare, emergency medicine physician at Northwestern Memorial Hospital in Chicago.

Based on the results of a survey released in 2010, the Harris Poll company reported that the number of American adults who had ever gone online to look for health information was 175 million, up from 154 million the previous year.

Among those who responded to the survey that they have consulted the internet about their own health, 53 percent said they discussed information they found with their doctors, up from 44 percent in 2009.

Changes in how medical care is insured and delivered, and the availability of online information, have prompted more people to become more proactive in their health care. And some patients find online information that can actually help them.

Pieter Ouwerkerk, a University of Chicago senior, said he regularly visits sites such as mayoclinic.com and uses a smartphone application called Epocrates.

The computer science and economics student believes the practice saved his life when a recent bacterial infection created an abscess in his throat, constricting his breathing. When two drugs he was given failed to help, Ouwerkerk checked Epocrates, returned to the doctor and asked to be prescribed prednisone, a synthetic steroid.

"It reduced the swelling, and I was back on my feet and cured in 30 minutes," Ouwerkerk said.

Ouwerkerk, who's 21, said he believes it has become a common practice "to get instant knowledge about a medical issue to decide if it requires a visit to the hospital or if you can fix it yourself."

That's where some medical professionals get worried. While many doctors praise patient research if it prompts the patient to seek medical attention, they worry that such research can also dissuade people from getting a proper checkup when one might be warranted.

They also warn that for every patient like Ouwerkerk, there are many others who are misled by what they find online.

One problem, noted Patrick McGrath, director of the Center for Anxiety and Obsessive Compulsive Disorders at the Alexian Brothers Behavioral Health Hospital in Hoffman Estates, is that many conditions, both minor and serious, have overlapping symptoms.

"All they have to do is look something up, and you've got 900 hits," he said. "Even if it's a minor thing like skip in heartbeat or change in blood pressure, it's now a symptom of 900 different" health concerns.

Another problem is that many websites don't address the prevalence of an illness, said Cheryl Carmin, professor at and director of the Stress and Anxiety Disorders Clinic at the University of Illinois at Chicago. Not everyone has the background to know that a muscle ache is much more likely to be caused by a cold or sprain than meningitis.

And cyberchondriacs who can't seem to accept their doctors' counterdiagnoses — even after several visits or conversations with their physicians — sometimes prompt another type of referral: to a mental health professional. Experts say patients who repeatedly refuse to accept doctors' findings sometimes have a psychiatric condition that is treatable.